Impaired Wound Healing in Diabetic Foot Ulceration

糖尿病足溃疡(DFU)是严重损害患者生活质量的主要问题， 导致长时间住院，并可能需要进行重大截肢。我们单位以前的工作是 显示皮肤血流量和氧合减少，足部能量储备减少 糖尿病患者的肌肉。这项研究的主要假设是皮肤中的这些异常 微循环和肌肉代谢是导致足底糖尿病足部溃疡无法治愈的原因。在……里面 此外，我们假设伤口愈合率与循环次数有关。 内皮祖细胞(EPC)。为了探索我们的假设，我们计划对糖尿病患者进行跟踪调查 足底溃疡患者为期12周。据估计，这一人口中的35%-45%将 在此期间实现伤口的完全愈合。一组足部风险较低的糖尿病患者 溃烂和一组健康对照受试者也将被纳入研究对象，因此与具有 可能会造成足部溃疡。我们将评估皮肤微循环血管反应性，局部组织 使用医学高光谱成像(MHSI)和循环的氧气输送和氧气提取 基线、4周、8周和12周的内皮祖细胞(EPC)和足部肌肉代谢，使用3T MRI稀有技术，在0周和12周。我们假设高光谱组织氧饱和度 糖尿病足高危患者的SHSIO2、肌肉代谢和循环内皮祖细胞减少 溃烂，这种减少将在无法治愈溃疡的患者中更加明显，我们 进一步假设氧输送和氧摄取的增加与血管生成有关 在那些没有愈合的患者中，伤口愈合所需的反应将不那么明显。 他们的溃疡。我们认为，这项建议包括跨学科、翻译和临床部分。 这将增加我们在一个非常重要的领域的知识，并将帮助我们更好地理解 DFU伤口愈合的病理生理学研究。我们还相信，这种知识的积累将 为开发新的治疗策略铺平道路，这些策略将极大地提高我们在 管理这一状况。此外，我们相信这将有助于理解两国关系 心血管疾病和伤口愈合之间的关系。

Diabetic foot ulceration (DFU) is a major problem that significantly impairs the quality of life of the patient, leads to prolonged hospitalization and may require a major amputation. Previous work from our unit has shown that there is reduction in skin blood flow and oxygenation and reduced energy reserves of the foot muscles in diabetes. The main hypothesis for this study is that these abnormalities in the skin microcirculation and muscle metabolism are responsible for the failure to heal plantar diabetic foot ulcers. In addition, we hypothesize that the rate of wound healing is associated with the number of circulating endothelial progenitor cells (EPCs). In order to explore our hypotheses, we plan to follow up diabetic patients with plantar foot ulceration for a 12-week period. It is estimated that 35%-45% of this population will achieve complete wound healing during this period. One group of diabetic patients at low risk of foot ulceration and a group of healthy control subjects will also be enrolled so comparisons with the group with foot ulceration can be made. We will evaluate skin microcirculation vascular reactivity, localized tissue oxygen delivery and oxygen extraction, using Medical Hyperspectral Imaging (MHSI) and circulating Endothelial Progenitor Cells (EPCs) at baseline, 4, 8, and 12 weeks and foot muscle metabolism, using a 3T MRI RARE technique, at 0 and 12 weeks. We hypothesize that hyperspectral tissue oxygen saturation (SHSIO2), muscle metabolism and circulating EPCs will be reduced in the diabetic patients at risk of foot ulceration and that this reduction will be more pronounced in the patients who fail to heal their ulcers, We further hypothesize that the increase in oxygen delivery and oxygen extraction related to the angiogenic response required for wound healing will be less prominently observed in those patients who do not heal their ulcers. We believe that this proposal includes interdisciplinary, translational and clinical components that will increase our knowledge in a very important field and will help us to better understand the pathophysiology of wound healing in DFU. We also believe that the accumulation of such knowledge will pave the way to the development of new therapeutic strategies that will greatly enhance our efficacy in managing this condition. In addition we believe that it will be helpful in understanding the relationship between cardiovascular disease and wound healing.